A UCLA-led analysis of more than eight million emergency visits suggests that New York’s tenant right-to-counsel program protects health in the neighborhoods that need it most, just as legal-aid capacity is straining.
NEW YORK, New York (Mamdani Post) – Giving poor tenants a lawyer when a landlord tries to evict them does more than keep a roof overhead. In the city’s highest-risk neighborhoods it also appears to keep people out of the emergency room. That is the central finding of a recently published peer-reviewed study, and it lands at a moment when the program it examines is stretched thin.
What the researchers measured
The paper appeared in the Journal of General Internal Medicine, and the lead author is Dr. Katherine L. Chen, an internal medicine physician and population health scientist at UCLA’s David Geffen School of Medicine. According to the UCLA Health release announcing the findings, the team examined more than 8 million emergency department visits between January 2016 and February 2020, limited to New York City residents who were on Medicaid or uninsured.
The design is what makes the result interesting. New York’s right-to-counsel program, created in 2017 as the first of its kind in the country, did not appear everywhere at once. It began in 10 zip codes with high eviction risk, homelessness and scarce housing, then expanded in phases. That staggered rollout let the researchers compare places and periods with a lawyer guarantee against those without, a so-called natural experiment. The program works through contracts with nonprofit law offices that represent low-income tenants in eviction proceedings. Twenty-six other US jurisdictions, Los Angeles among them, have since adopted similar programs.
Where the effect showed up
Across all covered neighborhoods the researchers found no overall association with emergency visit rates, though they estimated a slight dip. The signal sharpened where the stakes were highest. In the first phase of the rollout, the highest-risk neighborhoods, there were more than 26 fewer emergency visits per 10,000 residents, a statistically significant reduction. Subgroups at elevated risk of eviction also showed lower rates of all-cause visits. In the second and third phases, rates stayed about the same, News-Medical’s write-up of the paper notes.
Chen put the lesson plainly in the university’s statement, saying the result “underscores the importance of housing stability for overall health.” A tenant who keeps the apartment keeps the pharmacy, the clinic, the commute and the routine. A tenant thrown out of one loses all four at once. The finding fits that common-sense account, and it gives the city a public-health argument for legal aid that does not depend on anyone’s view of landlords.
The caveat that deserves honest treatment
The study also found something its authors did not expect: emergency visits for mental health and substance use conditions rose in the zip codes where the program operated. The researchers floated two possible explanations. Contact with a lawyer might prompt people to seek care for conditions that had gone untreated, or the stress of litigation might add short-term strain. Chen said the finding “definitely warrants further research,” according to the News-Medical report, and the team plans to link eviction records to health data and conduct patient interviews.
It would be a mistake to wave this away, and equally a mistake to read it as an argument against lawyers. Housing court is an adversarial, frightening place whether or not a tenant is represented, and an observational study ending in early 2020 cannot separate the effect of counsel from everything else happening in those neighborhoods. What the result does suggest is that legal representation should travel with social services, including mental health outreach, rather than stand alone.
A guarantee that is thinning on paper
The health data arrive against a backdrop of strain. In a 2025 report summarized by the Brooklyn Reader’s coverage of the comptroller’s findings, Comptroller Brad Lander found that overall representation of eligible tenants had fallen to 42 percent from 71 percent, and in the Bronx to 31 percent from 88 percent. Eviction filings had risen 440 percent after the pandemic moratorium ended. Attorneys at legal-services organizations were carrying 50 to 80 cases a year, above the recommended maximum of 48, and staff attrition at those groups ranged from 20 to 55 percent in 2022.
Tenants with full legal counsel in the 2024 fiscal year stayed housed at a rate of 89 percent, the report found. The law covers households earning up to 200 percent of the federal poverty line, about $53,300 for a family of three. Lander said the law’s promise was one the Adams administration “has utterly failed to keep,” and he recommended a five-year plan to meet the obligation, reformed provider contracts, and payment of providers on time.
What the city and state should do now
We found no new announcement on right-to-counsel funding in the coverage reviewed for this article, and that silence is the story. The Mamdani administration has made tenant power a defining commitment, and the rent freeze that took effect on October 1 shows it will use the tools it has. A freeze limits what a landlord can demand; a lawyer limits what a landlord can do to a family that cannot pay or that has been wrongly accused. The two work together, and the second is currently underbuilt.
The Lander recommendations are a ready-made agenda: pay the legal-services providers promptly, bring caseloads down to the recommended level, and make staff jobs viable enough to stop the attrition. Albany has its own part to play, since the same report urged a statewide right to counsel with the state covering half the cost. None of this requires waiting for more research. The new study adds a clinical reason to a moral one: keeping people housed appears to keep some of them out of the emergency room, and the best eviction defense is the one that arrives before anyone loses a home.
Readers looking for a lighter angle on City Hall can find one at Bohiney Magazine, although the numbers above are no laughing matter for the households behind them.
SOURCE: https://bohiney.com/